Quality Health Care in a Beautiful Setting: Part Two
Carmen Barroso, Regional Director
This is part 2 of a three part series. Click here to read part one.
The tiny baby was hugely distressed: Being tested for HIV just a few weeks after her birth was not her idea of a good time. Crying her lungs out, she made her discomfort loud and clear.
Enter Suze Holband, the Director of S’Lands Hospitaal’s Parent and Child Program. Through the program, HIV positive women receive HIV treatment as well as contraceptive counseling and cervical cancer prevention as any woman would receive in Suriname’s bustling capital of Paramaribo. Holband momentarily steps out of her job description to cradle the baby in her arms, whispering magical words that immediately calm her down. She charms babies and adults alike with her wide smile, exuding warmth and love of life.
But don’t be fooled: In Suriname, where two of the leading causes of death are AIDS and reproductive cancers, Holband’s role in overseeing the country’s prevention programs for cervical cancer and mother-to-child transmission of HIV is one of the toughest jobs around. Yet she does not shy away from the challenge. Her eyes light up when she tells me about of the countless babies who were able to remain HIV negative thanks to the treatment their mothers received in S’Lands hospital. Her face suddenly turns somber when she refers to the few that “she lost.”
Holband also becomes emotional when she recounts the young women that have died as a result of botched abortions. We talk at length about the huge number of abortions in Suriname, where abortion is illegal except in cases where the life of the woman is threatened.
Most are done safely by professionals who empathize with women’s needs and respect their rights, even if the law does not allow it. However, the number of deaths from unsafe abortion remains high, despite of the fact that contraceptives are relatively accessible. Young women, in particular, tend to have sex without protection. When I ask why, Holband becomes emphatic: because we don’t talk about sex!
In Suriname, as in every other country in the Americas and the Caribbean, adolescents are the ones who have the largest unmet need for contraception, despite the fact that many are sexually active. According to the Guttmacher Institute, up to half of sexually active unmarried women in the region are not using any contraceptive method, and Suriname is not excluded from these figures.
The majority do not want to get pregnant, and despite the fact that most know how to avoid a pregnancy, very few use a condom or a pill. Contraceptives are not distributed in schools or in other places where adolescents normally go, and they are expensive, particularly for poor adolescents.
For adolescents of all social classes, the weight of old taboos make it difficult to have frank conversations with their peers and their parents about life choices and the exercise of pleasurable and responsible sexuality. Further, as in many countries, entrenched gender discrimination is at play: nice young women are not supposed to have sex, much less to talk about it.
The consequences of this silence can be terrible for adolescents and devastating for communities. It is time to recognize the sexual rights of youth everywhere!